Re: Correlating nutrition to recent cancer mortality statistics.

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Abstract
Wynder and Cohen ( 1 ) attribute the declining mortality from breast, prostate, and colon cancers ( 2 ) as well as from cardiovasular disease ( 3 ) to the reduction of total fat intake in the U.S. population in recent decades. The authors are fully aware of the differential effect of saturated, polyunsaturated, and monounsaturated fat on physiologic parameters and human disease risk—in fact, they have been major scientific contributors in this area. From the perspective of the U.S. population, it may make little difference to focus on total rather than saturated fat, although evidence incriminating saturated fat is strong for prostate cancer but weaker for cardiovascular disease and colorectal cancer and weaker still for breast cancer. The dominance, however, of the English language scientific and general press in the world scene has adversely affected the attitudes toward total fat intake in the Mediterranean countries in which most of the total fat is monounsaturated and is in the form of olive oil ( 4 ). There is strong evidence that consumption of olive oil may convey substantial protection against coronary heart disease ( 5 ), and several studies have indicated that it may also provide some protection against breast cancer ( 6 ) and possibly other forms of cancer ( 7 ) and even against osteoporosis ( 8 ). Mediterranean countries have lower rates of occurrence of these diseases and conditions in comparison to the United States, even though total fat intake has been as high or higher than that in the United States. The overall evidence points to a beneficial effect of olive oil on human health. Although the data may not be strong enough to dictate substitution of olive oil for other types of lipids in populations who do not traditionally consume it, they strongly suggest that the Mediterranean populations should not risk diverting from their olive oil-centered dietary habits.